OMB Control Number 2090-0028

Expires 6/30/2015

The Future of the 

Chesapeake Bay 

A Brief Survey

The Clean Water Act authorizes collection of this information. All responses will be kept confidential to the extent permitted by law. 

Response to this survey is voluntary and no action will be taken against you if you choose not to take part. The public reporting burden 

for this form is estimated to average 5 minutes per response. Send comments regarding the burden estimate or any other aspect of

this form to the Director, Collection Strategies Division, U.S. Environmental Protection Agency (2822T), 1200 Pennsylvania Ave., NW, 

Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not send the survey materials to this address.

DRAFT
1

The Chesapeake Bay Watershed

The Watershed 

Is shaded in light grey on 

this map. 

It includes about 4,200 

freshwater lakes. 

Water draining from lands 

in the Watershed enters 

rivers and streams and 

eventually the Chesapeake 

Bay. 

This survey asks you about two types of water bodies in the Chesapeake Bay Watershed — the 

Chesapeake Bay itself and Lakes in the Watershed. Each has different characteristics and 

potential water quality concerns.

The Chesapeake Bay

Is an estuary where freshwater mixes with 

saltwater from the ocean. It is the largest 

estuary in North America and the third 

largest in the world.

As shown in dark grey on this map, the 

Bay includes portions of the 50 rivers that 

flow into it, for example: 

The James River up to Richmond, VA

The Potomac River up to 

Washington, DC

Please use this definition of the 

Chesapeake Bay when answering 

questions on this survey. 
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2. On average, how often do you see the following water bodies? (Please check 

ONLY ONE box in each row.)

3. In the last five years, have you participated in recreational activities

(including swimming, boating, fishing, or viewing nature) at the... 

(Please check ONLY ONE box in each row.)

4. Before taking this survey, were you aware that too much nutrients or sediment 

can degrade water quality?

 □ Yes □ No □ Don’t know

Chesapeake Bay: □ Yes □ No □ Don’t know

Watershed Lakes: □ Yes □ No □ Don’t know

Never Less than 

once a month

More than 

once a month Don’t Know

Chesapeake Bay: □ □ □ □

Watershed Lakes: □ □ □ □

1. Before receiving this survey, had you heard of the Chesapeake Bay?

□ Yes □ No □ Don’t know
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5. Please rate how much you agree or disagree with the following statements.

(Please circle one number for each statement.)

Strongly 

Disagree

Strongly 

Agree

Don’t 

Know

It is important to improve waters in the 

Chesapeake Bay Watershed, no matter 

how high the costs. 

1 2 3 4 5 DK

I am against any more regulations and 

government spending. 1 2 3 4 5 DK

My household should not have to pay any 

amount for programs to improve Bay 

Waters and Watershed Lakes.

1 2 3 4 5 DK

It is often difficult for me to find time to 

take surveys. 1 2 3 4 5 DK
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Thank you very much for your help.

Please mail this completed survey back to us in the postage-paid return envelope provided. 

Questions about you and your household

Finally, we would like to ask a few questions about you and your household. 

Your answers will not be saved or stored in a way that can be associated with your 

name or address. You will not be contacted about your responses or this survey. 

16. What is your sex? □Male □Female

17. What is your age? _____ years old

18. How many children under age 18 are living in your home? _____children

19. Have you or any member of your family ever worked in any of the 

following industries or jobs?

□Agriculture □Tour guide for fishing

□Commercial fishing □Environmental non-profit group

□No one in my family ever worked in these industries

20. In 2012, what was your total pre-tax household income, including all 

earners in your household?

□Under $25,000 □$100,000-$149,999

□$25,000-$49,999 □$150,000-$199,999

□$50,000-$74,999 □$200,000 or more

□$75,000-$99,000

21. Are you of Hispanic, Latino, or Spanish origin? □ Yes □ No

22. What is your race? (Select one or more.)

□ American Indian or Alaska Native □ Asian

□ Black or African American □ White

□ Native Hawaiian or Other Pacific Islander

23. What is the highest degree or level of school you have completed?

□ Elementary or high school, but no high school diploma or GED

□ High school diploma, GED, or other high school completion

□ Some college credit, no degree 

□ Associate’s Degree (for example: AA, AS)

□ Bachelor’s Degree (for example: BA, BS)

□ Master’s degree, professional degree, or doctorate degree 

(for example, MA, MSW, MD, DDS, JD, PhD, EdD)
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Thanks again for completing this survey

If you have any questions please call XXX-XXX-XXXX 

or email chesapeake-survey@abt.com.